One geriatrician for every 5,000 Americans age 65 and older

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No specific training, low Madicare reimbursements : nothing is made to attract young students into geriatric. Salaries for geriatricians range between $160,000 and $181,000. By comparison, cardiologists – who have a large percentage of older patients – earn $247,000 to $278,000. The federal government last year even cut a $34 million appropriation for geriatric training.
Arthur Altbuch was among the 1,678 doctors who, in 1989, became the first in the nation to be certified in geriatric medicine, then an emerging specialty focused on the health care of older persons.
Despite the potential, few doctors have followed in Altbuch’s footsteps. A 2005 American Geriatrics Society report found that of more than 650,000 practicing physicians nationwide, fewer than 7,000 were certified geriatricians, or one for every 5,000 Americans age 65 and older. And it appears the slim ranks have been shrinking recently.
By 2030, the geriatrics society estimates, the nation will be about 36,000 geriatricians short.
Altbuch said the lack of interest in the field is in part due to a commonly cited preconception: that doctors think treating chronically ill elders will be depressing and unglamorous. But he says another factor is an increasing influence: Medicare.
“Medicare is the worst payer class in my practice,” said Altbuch.
The Web site Physician Salaries USA reports annual base salaries for geriatricians range between $160,000 and $181,000, depending on where the doctor lives.
By comparison, cardiologists – who have a large percentage of older patients – earn $247,000 to $278,000, with higher amounts for those doing procedures such as angioplasties.
One reason geriatricians take home less is that there are no specialized tests. Dr. Robert Butler, a Pulitzer Prize winning author and one of the nation’s leading proponents of geriatric medicine, said it’s unrealistic to expect the number of geriatricians to ever catch up with the demand. A better approach is to require medical schools to have in-depth geriatric training for all students, with the same for doctors doing internships and residencies.
Yet Medicare also shortchanges geriatric education, Butler says.
The program, which funnels more than $2 billion to medical schools and teaching hospitals annually, provides only one year of fellowship training for geriatrics when at least four are necessary, says Butler, who heads the International Longevity Center in New York City, which advocates more geriatric medical faculty development.
The federal government last year cut a $34 million appropriation for geriatric training, Butler said. Only five medical schools – one of the most recent being at FSU – have full geriatric departments.

(The Bradenton Herald, 12/2/06, “Doctors shun geriatric medicine”)

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